Physician Assistant Salary in Kentucky 2026,
$120,760 Median | BLS Data by City

A median $120,760 a year, or $58.06 an hour, per BLS OEWS May 2025 — 11.1% below the national median of $135,880. The middle half falls between $102,430 and $136,080 and the full band runs $79,550 to $161,820. The 75th percentile just clearing the national median is the useful detail: the commonwealth's better roles are nationally competitive.

Louisville/Jefferson County at $130,830, then Paducah $124,990 and Lexington-Fayette $112,230 — the only three published metros. More than eighteen thousand dollars separates the top and bottom, which for a state this size points to differences in practice setting, with Louisville's hospital and specialty employment lifting its figure.

Through the Kentucky Board of Medical Licensure, the same board that licenses physicians. You need a degree from an accredited physician assistant programme and NCCPA national certification, and you practise under a supervising physician arrangement with delegated authority. Kentucky's prescriptive arrangements have changed in recent years, so read the supervision agreement and the current prescriptive position together rather than assuming either from another state.

The regulatory contrast with nurse practitioners is the most plausible explanation. Kentucky employs physician assistants at 0.65 times the national rate and nurse practitioners at 1.15 times, and the two professions do substantially overlapping work. Nurse practitioners here can have the non-scheduled prescribing agreement released after a qualifying period; physician assistants practise under a supervising physician arrangement throughout. In rural counties where physicians are scarce, that difference decides which profession a practice can actually deploy.

Mixed, and it depends on where. The flat 4.0% income tax and low housing costs make a $120,760 median go further than it would in most states, and the $136,080 seventy-fifth percentile clears the national median. Against that, there are only about 1,360 posts, roughly 100 openings a year, and the supervising physician requirement constrains where you can practise — particularly in the eastern counties where the need is greatest.

Because the regulatory requirements differ in a way that matters most exactly where the need is greatest. A Kentucky nurse practitioner can, after a qualifying period, prescribe non-scheduled medications without maintaining a physician agreement; a Kentucky physician assistant practises under a supervising physician arrangement for the duration. In an eastern Kentucky county with one physician covering several communities, that difference determines which advanced practice clinician a clinic can realistically deploy — and the employment data reflects it, with nurse practitioners at 1.15 times national concentration and physician assistants at 0.65. It is not a statement about clinical capability; it is a statement about what the rules permit in a state with a physician shortage.

The 10th percentile of $79,550 sits more than twenty-two thousand dollars below the 25th, so the bottom of this band mixes part-time and contingent work with early-career practice. With about 1,360 physician assistants the sample is modest, and only three metros are published, leaving most of the commonwealth outside the table. The code covers primary care, emergency, surgical and specialty practice at genuinely different rates, and it excludes call stipends and productivity arrangements.

Specialty first: surgical first assisting, emergency medicine and procedural practice are what the $136,080 seventy-fifth percentile and $161,820 ninetieth describe, and both clear the national median. Setting second — hospital and specialty employment above primary care and community clinic work, which is largely what the eighteen-thousand-dollar Louisville-to-Lexington gap measures. Full-time status third, given the wide gap at the bottom of the band. Lead advanced practice provider roles fourth. The supervision agreement matters throughout, because what it delegates is what you can be paid for.